The American Family Physician is a peer reviewed journal put out by the American Academy of Family Physicians about twice a month. Although to read every word would take several hours per edition, I feel like I can make a pretty fair pass through it in about an hour. None-the-less copies seem to accumulate on my desk as well as the desks of some of my associates, and I thought readers, family docs and others, might enjoy a very fast summary of this family doctor’s take on what’s really interesting in each edition. So here is my first pass at AFP in 2 minutes:
1.5 million Americans live in nursing homes. Another million are in assisted living. This article is a snooze.
More interesting stuff here. Consider liberalizing diets to avoid weight loss from poor calorie intake. Try to avoid feeding tubes. Rarely do they lead to good outcomes. When using opioids review other meds for drug interactions, especially oversedation. Same with drugs for urinary incontinence. Drug adverse effects are very common, consider any new symptom a drug effect until proved otherwise.
Tough issue here is diagnosis. Keep up your index of suspicion, presents as 2-4 week illness with mono or influenza like symptoms. Diagnostic test is for acute HIV infection is HIV viral RNA. Estimated 56,300 new cases in 2006.
About 300,000 adult survivors of childhood cancer out there. Overall nothing startling here. Try to have a complete summary of cancer treatment on the patient’s chart, so you can figure out what they are at risk for.
This boils down to do what you can to encourage women to breastfeed. There is a some marginal data that supports the effectiveness of physician encouragement.
Most people become delirious before they die. Duh? You can skip this one.
Nice to have an alternative to allopurinol. Good news is it gives us an alternative in cases of allopurinol allergy, or failure. Bad news: expensive ($160./ month) more hepatic toxicity and although it works better, allopurinol works well enough.
Bottom line is if hoarseness needs evaluation, the thing to get done is visualization of the vocal cords and larynx, not a bunch of other imaging and tests.
Comments of whether anyone likes this post will be appreciated. If you like it forward it on to your FP and primary care colleagues.